Previous studies indicate that Kentucky has a high mortality rate for cardiovascular disease and a high prevalence of inadequately controlled hypertension. The present study proposes to develop and evaluate the effectiveness of a rural community high blood pressure control project utilizing existing community resources. The study will be undertaken in a rural Kentucky community which has a successful ongoing hypertension detection and follow-up project conducted by the local health department. High blood pressure control activities will include educational efforts directed to the general public, individuals with elevated blood pressures, and health care providers. The primary emphasis will be to increase awareness of hypertension and other cardiovascular disease risk factors, as well as to improve patient compliance with hygienic and pharmacologic antihypertensive therapies. Because previous studies indicate that adolescents in Kentucky have a high prevalence of elevated blood pressure, special self-instructional educational materials to increase cardiovascular disease risk factor awareness will also be developed for use in the secondary schools. Using the successful Agriculture Cooperative Extension Service efforts in assisting rural families to identify and solve problems affecting their welfare as a model, we will develop and evaluate a program in which Extension Service paraprofessional personnel assist hypertensive patients and their families with acceptance and adjustment to recommended changes in lifestyle. Provider education will include the development of a hypertension syllabus, one week University based mini-residencies in hypertension for physicians, and a series of hypertension seminars. Evaluation of the overall program will include a Year 1 and Year 5 general population household survey to assess changes in blood pressure and health related attitudes and behavior over time in both the study community and a similar comparison community not exposed to community high blood pressure control activities. Effectiveness of specific educational efforts and program costs will be evaluated.